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    grandrounds@dshs.texas.gov


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GRAND ROUNDS:

Encouraging a Culture of Learning and the Integration of Evidence into Practice

E-mail updates

Spring 2019 Semester

Presentations are held on Wednesdays from 11:00 a.m. to 12:30 p.m. Central Time in Austin (1100 W. 49th Street, see map) or via webinar.

PLEASE NOTE THE ROOM LOCATION FOR EACH DATE, AS THEY HAVE CHANGED: 

April 17: Health Communication: Designing Effective Messages to Promote Behavior Change Room: M100
April 24: Partnering for Research, Policy and Equity: Collaboration between State Public Health and Academia Room: M100
May 1: Leveraging Technology to Reduce Health Inequities in Pediatric Chronic Disease Room: K100
May 8: Hansen’s Disease (Leprosy) in Texas: Old World Disease, New World Resources Room: M100
May 15: Operation Naloxone: A Harm Reduction First Model for Addressing the Opioid Crisis Room: K100
May 22: Superbugs and How to Prevent Their Spread Room: M100

*"live" = not recorded


mackert, michael
Michael Mackert, PhD

Director of The University of Texas at Austin Center for Health Communication and Professor in the Stan Richards School of Advertising & Public Relations and Department of Population Health

Health Communication: Designing Effective Messages to Promote Behavior Change

Health Communication: Designing Effective Messages to Promote Behavior Change

Presenter:
Michael Mackert, PhD
Director of The University of Texas at Austin Center for Health Communication and Professor in the Stan Richards School of Advertising & Public Relations and Department of Population Health

Description
Better health communication is essential not just to raising awareness about health issues, but also to promote behavior change and improved outcomes. This presentation will focus on the development of more effective health messages which can be used in settings ranging from interpersonal communication to mass media and digital health campaigns. Issues related to health literacy and clear communication will be covered, as well as audience-centered approaches to developing effective messages that are grounded in more of an advertising perspective

Learning Objectives:
Describe the importance of health literacy as it relates to developing clear and engaging health messages.

Discuss the fundamental steps of health campaign message design.

Characterize an audience-centered approach to developing more effective messages.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Licensed Marriage and Family Therapists 
  • Licensed Professional Counselors
  • Licensed Psychologists 
  • Registered Dietitians
  • Registered Sanitarians
  • Social Workers

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Suggested Resources:
Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016; 132:3-12.

Mackert M, Mabry-Flynn A, Champlin S, Donovan EE, Pounders K. Health literacy and health information technology adoption: the potential for a new digital divide. J Med Internet Res. 2016; 18(10):e264. Free full text available at  https://www.ncbi.nlm.nih.gov/pubmed/27702738

Manganello J, Gerstner G, Pergolino K, Graham Y, Falisi A, Strogatz D. The relationship of health literacy with use of digital technology for health information: implications for public health practice. J Public Health Manag Pract. 2017; 23(4):380-387.

Pope JP, Pelletier L, Guertin C. Starting off on the best foot: a review of message framing and message tailoring, and recommendations for the comprehensive messaging strategy for sustained behavior change. Health Commun. 2018; 33(9):1068-1077.

Making Health Communication Programs Work produced by the National Cancer Institute

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mullen, jewel 2
Jewel Mullen, MD, MPH

Associate Dean for Health Equity, Dell Medical School 

Partnering for Research, Policy and Equity: Collaboration between State Public Health and Academia (2)

Partnering for Research, Policy and Equity: Collaboration between State Public Health and Academia

Location: Room M100

Presenter:
Jewel Mullen, MD, MPH

Associate Dean for Health Equity, Dell Medical School 

Description

The increasing focus on population health, social determinants and equity, along with the ongoing call for a health in all policies approach across multiple sectors, could be the opportunity for state public health to steer population health improvement at the local, state and federal levels. However, the prioritization of community-driven approaches to population health improvement sometimes raises uncertainty about state public health’s contribution to those efforts. In contending that the leadership of state health agencies remains essential, this presentation will address the importance of inter and intra-agency collaboration, academic partnerships, and shared accountability for health equity.

Learning Objectives:
Describe strategies for building collaboration within and across state agencies.

Explain effective ways to demonstrate the meaning and value of public health and health equity.

Identify characteristics of effective academic institution-state health agency collaboration. 

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Registered Sanitarians
  • Social Workers

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Suggested Resources:
de Montigny JG, Desjardins S, Bouchard L. The fundamentals of cross-sector collaboration for social change to promote population health. Glob Health Promot. 2017; e-pub on August 14, 2017. 10.1177/1757975917714036

Gyllstrom E, Gearin K, Nease D Jr, Bekemeier B, Pratt R. Measuring local public health and primary care collaboration: a practice-based research approach. J Public Health Manag Pract. 2018; e-pub on Jun 7, 2018. 10.1097/PHH.0000000000000809.

Lee AF, Quade T, Dwinnells R. Evolution of the academic health department through public health academic and practice collaborations. J Public Health Manag Pract. 2014; 20(3):290-6.

Pratt R, Gyllstrom B, Gearin K, Hahn D, VanRaemdonck L, Peterson K, Baldwin LM. Primary care and public health perspectives on integration at the local level: a multi-state study. J Am Board Fam Med. 2017; 30(5):601-607. Free full text available at https://www.ncbi.nlm.nih.gov/pubmed/28923812

Towe VL, Leviton L, Chandra A, Sloan JC, Tait M, Orleans T. Cross-sector collaborations and partnerships: essential ingredients to help shape health and well-being. Health Aff (Millwood). 2016; 35(11):1964-1969. 

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lopez, keila
Keila N. Lopez MD, MPH
Assistant Professor, Pediatrics
Director, Transition Medicine
Division of Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine


Leveraging Technology to Reduce Health Inequities in Pediatric Chronic Disease

Leveraging Technology to Reduce Health Inequities in Pediatric Chronic Disease

Location: Room K100

Presenter:
Keila N. Lopez MD, MPH
Assistant Professor, Pediatrics; Director, Transition Medicine, Division of Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine

Description
Disparities in the medical care provided to the growing chronic disease adolescent survivor population exist, and involve:

  1. poor care transition (an age and developmentally appropriate process, addressing the medical, psychosocial and educational/vocational aspects of care) from child-centered to adult-centered healthcare, and 
  2. lack of appropriate transfer of care (the point at which an adult cardiac provider assumes the medical care of a former pediatric patient).

Finding innovative ways to improve transition and transfer of care for pediatric patients with chronic disease is critical to successful long-term disease management and survival. Please join Keila Lopez MD, MPH, Texas Children's Hospital/Baylor College of Medicine for this thought-provoking discussion.

Learning Objectives:
Describe health inequities during the transition period for chronic disease adolescents.

Examine  the evolution of healthcare technology and adolescent use.

Discuss the role of technology on the adolescent brain.

Investigate technologies that may improve health inequities for chronic disease adolescents.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Registered Sanitarians
  • Social Workers

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Highly Recommended Resources:

TexasYouth2Adult Transition Tool
Texas Youth2Adult is an online tool to help families who have children with special health care needs or other disabilities successfully move from childhood to adulthood. With this tool, families can create personalized accounts and find medical, educational, social, financial, and employment resources and much more. This tool was created by Easter Seals of Greater Houston.

Got Transition  
Got Transition resources include the Six Core Elements of Health Care Transition, which define the basic components of health care transition support for providers. These include: establishing a transition policy, tracking progress, administering transition readiness assessments, planning for adult care, transferring care, and integrating into an adult practice.  
For Providers: The Six Core Elements of Health Care Transition  
Got Transition has also assembled transition planning steps that youth, parents and educators can take to make sure the transition to adult health care goes smoothly. Their website includes an interactive set of frequently asked questions with answers provided by experienced youth, young adults and parents.  
For Youth and Families: Got Transition Health Care Transition Resources

Navigate Life Texas website 
https://www.navigatelifetexas.org/en

Suggested Resources:
Everitt IK, Gerardin JF, Rodriguez FH, Book WM. Improving the quality of transition and transfer of care in young adults with congenital heart disease. Congenit Heart Dis. 2017; 12(3):242-250.

Lopez KN, O'Connor M, King J, et al. Improving transitions of care for young adults with congenital heart disease: Mobile app development using formative research. JMIR Form Res. 2018; 2(2): e16. doi: 10.2196/formative.9963. Free full text available at https://www.ncbi.nlm.nih.gov/pubmed/30574573

Twenge JM, Park H. The decline in adult activities among U.S. adolescents, 1976-2016. Child Dev. 2019; 90(2):638-654.

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kizilbash, annie
Annie (Quratulain) Kizilbash, MD, MPH 
Medical Director, Patient Services, Texas Center for Infectious Disease 

foy, elizabeth
Elizabeth Foy, RN, BSN

Tuberculosis and Hansen’s Disease Nurse Administrator
Texas Department of State Health Services


 

Hansen’s Disease (Leprosy) in Texas: Old World Disease, New World Resources

Hansen’s Disease (Leprosy) in Texas: Old World Disease, New World Resources

Location: Room M100

Presenters:
Annie (Quratulain) Kizilbash, MD, MPH 
Medical Director, Patient Services, Texas Center for Infectious Disease
Elizabeth Foy, RN, BSN

Tuberculosis and Hansen’s Disease Nurse Administrator, Texas Department of State Health Services

Description
Hansen’s Disease (HD), also known as leprosy, is a disease that many people don’t realize still exists. However, Texas has reported 101 newly identified cases from 2013-2017, and patients are treated in clinics supported by the Texas Department of State Health Services (DSHS). It is a curable disease of the skin and nerves that is caused by a bacteria carried by animals such as the armadillo. While difficult to contract, HD is thought to be transmitted by nasal secretions from persons with untreated disease. You cannot get HD from casual contact such as shaking hands or sharing a meal, and in fact most people are naturally immune to the disease. If untreated, HD can cause permanent deformity and disability. The goal of the DSHS HD Program is to prevent this through early diagnosis and treatment.

This Grand Rounds lecture will focus on the history and epidemiology of Hansen’s disease, how it’s transmitted and treated in Texas, and how new research is discovering more about this ancient bacteria.

Learning Objectives:
Discuss the incidence of Hansen’s disease (HD) in Texas and provide a brief epidemiological and historical overview of HD in the US

Describe how Hansen’s disease is contracted, transmitted and treated

Summarize the services provided by the Texas DSHS HD clinics in caring for patients with HD.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Registered Sanitarians
  • Social Workers

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Resources Mentioned During the Presentation:
STAR magazine: http://louisianadigitallibrary.org/islandora/object/lsuhsc-p15140coll52%3Acollection

Hansen's Disease in Texas: https://www.dshs.state.tx.us/idcu/disease/hansens.aspx

Questions and Answers 

Suggested Resources
National Hansen’s Disease Program

https://www.hrsa.gov/hansens-disease/index.html

Including “A Manual for the Care of Hansen’s Disease in the United States” 
NHDP, 8/2012 which is found here: https://www.dshs.state.tx.us/idcu/disease/hansens/standards.shtm

National Institute of Allergy and Infectious Disease:
https://www.niaid.nih.gov/diseases-conditions/leprosy-hansens-disease

Leprosy in the 21st Century
Cassandra White, Carlos Franco-Paredes
Clin Microbiol Rev. 2015 Jan; 28(1): 80–94. doi: 10.1128/CMR.00079-13
Article
 PubReader PDF–3.7MCitation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284303/

Guidelines for the Diagnosis, Treatment and Prevention of Leprosy, WHO 2018
https://apps.who.int/iris/handle/10665/274127

World Health Organization. Regional Office for South-East Asia. (‎2018)‎. Guidelines for the diagnosis, treatment and prevention of leprosy. World Health Organization. Regional Office for South-East Asia. http://www.who.int/iris/handle/10665/274127. License: CC BY-NC-SA 3.0 IGO

Centers for Disease Control and Prevention (CDC)
https://www.cdc.gov/leprosy/index.html

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hill, lucas
Lucas G. Hill, PharmD, BCPS, BCACP

Clinical Assistant Professor, The University of Texas at Austin College of Pharmacy Director, Operation Naloxone 

kinzly, mark
Mark Kinzly
Texas Overdose Naloxone Initiative

thibodeaux, charles ray 2
Charles Ray Thibodeaux, BAAS, LCDC
Texas Overdose Naloxone Initiative

burwell, annie
Annie Burwell, LBSW

Mobile Outreach Director, Emergency Mental Health, Overdose Response, MM Units, Williamson County Emergency Services

sledge, daniel
Daniel Sledge, BA, Licensed Paramedic

Lead Paramedic, Williamson County
Mobile Outreach Team

Operation Naloxone: A Harm Reduction First Model for Addressing the Opioid Crisis

Operation Naloxone: A Harm Reduction First Model for Addressing the Opioid Crisis

Location: Room K100

Presenters:
Lucas G. Hill, PharmD, BCPS, BCACP
Clinical Assistant Professor, The University of Texas at Austin College of Pharmacy; Director, Operation Naloxone
Mark Kinzly
Texas Overdose Naloxone Initiative
Charles Ray Thibodeaux, BAAS, LCDC
Texas Overdose Naloxone Initiative
Annie Burwell, LBSW
Mobile Outreach Director, Emergency Mental Health, Overdose Response, MM Units, Williamson County Emergency Services
Daniel Sledge, BA, Licensed Paramedic
Lead Paramedic, Williamson County Mobile Outreach Team  

Description
Recovery from opioid use disorder is complex, often requiring both medication and behavioral interventions...but people can’t recover from opioid use disorder if they’re dead. In this session, overdose prevention experts with diverse clinical backgrounds will describe their efforts, funded through the Texas Targeted Opioid Response, to keep Texans who use opioids alive by prioritizing harm reduction.

Learning Objectives:
Discuss harm reduction as a key approach to address the opioid crisis.

Compare national and state-level trends in opioid-related harm.

Describe the role of naloxone in opioid overdose prevention.

Examine community paramedic interventions to connect overdose victims to evidence-based treatment.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Licensed Chemical Dependency Counselors
  • Licensed Marriage and Family Therapists
  • Licensed Professional Counselors
  • Licensed Psychologists
  • Registered Sanitarians
  • Social Workers

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Suggested Resources
Rzasa LR, Galinkin JL. Naloxone dosage for opioid reversal: current evidence and clinical implications. Ther Adv Drug Saf. 2018; 9(1):63-88. Free full text available at https://www.ncbi.nlm.nih.gov/pubmed/29318006

Beletsky L, Burris SC, Kral AH. Closing death's door: action steps to facilitate emergency opioid drug overdose reversal in the United States. A conference report from: Center for Health Law, Policy and Practice; July 21, 2009; Philadelphia, PA. https://ssrn.com/abstract=1437163

Hill LG, Steiker LH, *Mazin L, Kinzly ML. Implementation of a collaborative model for opioid overdose prevention on campus (original research). J Am Coll Health. Published online ahead of print January 7, 2019.

Hill LG, *Sanchez JP, *Laguado SA, Lawson KA. Operation Naloxone: Overdose prevention service learning for student pharmacists (original research). Curr Pharm Teach Learn. 2018;10(10):1348-53.

Evoy KE, Hill LG, Groff L, Mazin L, Carlson C, Reveles KR. Naloxone accessibility without a prescriber encounter under standing orders at community pharmacy chains in Texas (original research). JAMA. 320;18:1934-7.

Mackert M, Pounders K, Brown L, Kirtz S, Hughes Wagner J, Ring D, Hill LG, Wilcox G, Murthy D, Tierney W, Innerarity S, McGlone M, Holleran-Steiker L, DeSalvo K, Bernhardt J, Pretorius K. Development of a health communication campaign to promote the Texas prescription monitoring program (original research). Health Mark Q. Accepted for publication

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ham, cal
Cal Ham, MD
Centers for Disease Control and Prevention

 

Superbugs and How to Prevent Their Spread

Superbugs and How to Prevent Their Spread

Location: Room M100

register now red FINAL(1)

Presenter:
Cal Ham, MD
Centers for Disease Control and Prevention

Description
This presentation by Dr. Cal Ham from CDC’s Antimicrobial Resistance Team in the Division of Healthcare Quality Promotion will focus on highly-resistant superbugs of concern in healthcare settings and strategies to prevent their spread.  Dr. Ham will discuss the underlying epidemiology of these emerging pathogens including Carbapenem-resistant Enterobacteriaceae (CRE), Candida auris, multidrug-resistant Acinetobacter baumannii, and carbapenem-resistant Pseudomonas aeruginosa. He will also describe the key roles healthcare providers and public health practitioners play in preventing the spread of these organisms, and the CDC’s novel resistance containment strategy.

Learning Objectives:
Describe the epidemiology, public health importance, and response activities for selected multi-drug resistant organisms (MDROs).

Describe CDC’s tiered approach for public health response to contain novel or targeted MDROs.

Discuss interventions to prevent spread of superbugs in healthcare including core infection control practices.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

  • AMA PRA Category 1 CreditsTM 
  • Continuing Nursing Education
  • Certified Health Education Specialists & Master-Certified Health Education Specialists
  • Certified in Public Health
  • Registered Sanitarians
  • Social Workers 

A certificate of attendance is available for those not seeking the credits/contact hours listed above.

Suggested Resources
Centers for Disease Control and Prevention. Interim Guidance for a Public Health Response to Contain Novel or Targeted Multidrug-Resistant Organisms (MDROs). https://www.cdc.gov/hai/pdfs/containment/Health-Response-Contain-MDRO-H.pdf Updated January 2019.

Shams AM, Rose LJ, Edwards JR, et al. Assessment of the overall and multidrug-resistant organism bioburden on environmental surfaces in healthcare facilities. Infect Control Hosp Epidemiol. 2016; 37(12):1426-1432. Free full text available at https://www.ncbi.nlm.nih.gov/pubmed/27619507

Snyder GM, Wright SB. The epidemiology and prevention of Candida auris. Curr Infect Dis Rep. 2019; 21(6):19.

Trivedi KK, Pollack LA. The role of public health in antimicrobial stewardship in healthcare. Clin Infect Dis. 2014; 59 Suppl 3:S101-3.

Woodworth KR, Walters MS, Weiner LM, et al. Vital signs: containment of novel multidrug-resistant organisms and resistance mechanisms – United States, 2006-2017. MMWR Morb Mortal Wkly Rep. 2018 Apr 6;67(13):396-401. Free full text available at https://www.ncbi.nlm.nih.gov/pubmed/29621209

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Last updated July 16, 2019